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May News 2013 (Issue #8)

Issue 8, May 31, 2013

Articles in This Issue:


Session Ends with Compromise

Iowa's 2013 legislative session has come to a close - three weeks after the scheduled end of the session.  Just three weeks ago people wondered how the Democratic Senate and Republican House could ever come to an agreement on the big issues; an agreement that Republican Governor Terry Branstad would sign.  Just three weeks ago, it seemed like there was no middle ground, and it also seemed like no one was talking to each other.  Talks that were happening ended in a stalemate, with both sides holding firm.

Many wondered how session would end.  It did end, and it ended because legislators reached across the aisle and worked out their differences.  The Republican controlled House needed Democratic votes to pass its final bill (the Health and Human Services Budget); the Democratic controlled Senate needed Republican votes to pass its final bill (Property Tax Reform).

“It’s amazing what happens when you talk to one another instead of over one another,” Senate President Pam Jochum of Dubuque said on the final night of session. “And that’s how we finally reached agreement on a lot of issues that a lot of people thought we would not be able to achieve this year.”

House Majority Leader Linda Upmeyer agreed, “Washington, D.C.’s divisive politics have no place here. This session we have shown that there is a better way. Working together toward a common goal means we can achieve truly great things.”

The Iowa Senate finished up their work shortly before midnight on Wednesday, March 22; the Iowa House made their final votes on Thursday morning, March 23, adjourning just before Noon.  In the end, lawmakers found a middle ground on the remaining issues:

  • Budget for next year (fiscal year 2014 which begins July 1, 2013)
  • Property tax reform
  • Health coverage to 150,000 low-income Iowans (Medicaid expansion)
  • Mental health and disability services redesign
  • Education reform

The Governor now has 30 days to sign the bills passed by the Iowa Legislature (until June 22).  The Governor can sign or veto bills that do not involve money.  Bills that spend money can be "line item vetoed" - that is, the Governor can veto parts of the bill, but sign the rest into law.  We will report on the Governor's action in our final session issue of INFONET (scheduled for June 28).

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Legislature Approves Plan to Expand Access to Health Care

One of the most difficult issues for Iowa lawmakers this year was tied to the very political "Affordable Care Act" (also known as "ObamaCare").  The federal Affordable Care Act (ACA) allowed states to expand their Medicaid programs to cover any person earning up to 138% of the federal poverty level. That's an annual income of $15,856 for a single person, or $32,500 for a family of four.  Before the ACA, a person had to fall into a specific category in order to receive Medicaid services, such as having a disability, having a child in the home, being pregnant, or being over age 65.

Typically, the Federal government pays for about 60% of the costs of Medicaid.  States that chose to expand Medicaid would receive an "enhanced Medicaid match" - with the Federal government picking up 100% of the costs for the first three years, then slowly lowering that match until it becomes a permanent at 90% in 2020 and beyond.  So Iowa would never have to pick up more than 10% of the costs of this expansion.

Prior to the start of session, Governor Terry Branstad rejected the idea of expanding Medicaid, saying it is too costly a program, does nothing to improve the health status of those in it, and the Federal government can't be trusted to live up to its funding commitment..  Most of the Republicans in the Iowa Legislature agreed, and liked the Governor's alternative plan (Healthy Iowa Plan) that would cover people with a combined approach to expand Medicaid services to some, and cover others with private health insurance plans. The plan would have been paid for with the traditional mix of state and federal dollars (40% state, 60% federal), including $40 million in county mental health and disability services property taxes.

In the end, the Legislature agreed to create a "Iowa Health and Wellness Plan" that used the Senate Democrats' financing plan (100% federal match) and used the Governor's health incentives and combined private insurance-Medicaid approach. The final agreement passed by the Legislature:

  • Creates the Iowa Health and Wellness Plan to provide health coverage for individuals with incomes up to 138% of the federal poverty level.     

    • Individuals with incomes up to 100% of the federal poverty level will receive services through Medicaid with a benefits package modeled after the state employees' health plan.  You can see the differences between those plans here.    

    • Individuals between 101-138% of the federal poverty level will be covered by a private insurance plan on the state's "insurance exchange" (although we do not know if people will choose between plans, or one will be chosen for them).  Their plans are paid for by the program if certain conditions are met.
  • People earning more than 50% of the federal poverty level will be charged monthly premiums, which are waived the first year.  So the coverage is "free" in this first year. 
    • If a person earning more than 50% of the federal poverty level completes the required preventive health services during that first year, premiums are waived for another year.  That continues as long as the person completes these prevention requirements annually. 

    • If a person does not meet the prevention requirements, they will have to pay monthly premiums to keep their coverage, but these are limited by the federal government (premiums and other cost-sharing requirements can't be more than 2% of a person's annual income). Preventive services include things like annual physicals, smoking cessation, diet counseling, mammograms, regular exercise, etc. (but a person isn't required to do all of these things - what is required will be outlined in DHS rules later this year).
  • Allows people to choose their doctor (called a "medical home") - the provider network includes all Medicaid providers and any providers that are a part of an approved Accountable Care Organization. 

    • If a person does not choose their medical home, DHS will assign them to one.  This "medical home" becomes the person's care coordinator, focusing on "whole person" health.  They are required to provide care coordination that provides links to community and social supports that help a person maintain a healthy lifestyle.  

    • Gives members a choice of providers within the network, but allows DHS or an Accountable Care Organization to limit that choice if a person is over-using the system, or the person's health condition would be better managed by another provider.
  •  Enrollment for the plans begins in October, but coverage will not begin until January 1, 2014.  

The Iowa Health and Wellness Plan passed the Iowa Legislature with bipartisan support - 80-17 in the Iowa House and 26-24 in the Iowa Senate (you can see how your legislator voted here). The plan requires a waiver from the Federal government because it is not a straight "Medicaid expansion" (which would have simply extended our current Medicaid program to people earning up to 138% of the federal poverty level).  The Iowa plan does a few things that trigger a waiver:

  1. Charges premiums.  Medicaid does not typically allow premiums to be charged (co-pays are allowed, but not premiums). Even though these are waived in the first year, a person must comply with certain wellness activities which are not yet identified in order to be waived in subsequent years.  Some organizations say this could cause disruption in coverage for some people, which means their access to health care will be limited.  Others say this is an important part of encouraging personal responsibility.

  2. Splits the coverage between Medicaid and private insurance plans.  Those earning up to 100% of the federal poverty level become eligible for a more limited Medicaid plan (one that matches the state employee benefits package).  It is unclear at this point as to whether these plans will have full mental health and substance abuse parity and include transportation (the existing state employee health benefit plan does not, but federal law requires such coverage).  Those earning between 101-138% of the federal poverty level get their coverage from a private insurance plan and their benefits may or may not be equal to those in the first group.  it is also unclear as to whether this group will get a choice in providers on the Insurance Exchange, or if that choice will be made for them.

  3. Allows Medicaid to assign providers to some.  The Iowa Medicaid Enterprise is allowed to limit a person's choice in health care provider if they are over-using the system, or another provider would improve heatlh outcomes for that person.  Accountable Care Organizations are allowed to do the same, with Medicaid approval, for people enrolled in their programs.

States (like Iowa) that are requesting a waiver from certain Medicaid rules are required to hold hearings to allow public comment on the plan.  Four meetings have been scheduled, but the plan needs to be revised to reflect legislative action.  You can read more about the plan, and updates to the public meeting schedules here.

If you would like to know more about the plan or comment on it, you can do so in three ways:

  1. ATTEND A PUBLIC HEARING.

    June 3, 2013 at 9:00 am (DES MOINES)
    River Place - Room 1, 2309 Euclid Avenue

    June 3, 2013 at 1:00 pm (SIOUX CITY)
    Wilbur Aalfs (Main) Library - Gleeson Room. 529 Pierce Street

    June 3, 2013 at 1:30 pm (DAVENPORT)
    Scott County Administration Building, 1st Floor Board Room (inside building lobby), 600 West Fourth Street

    June 4, 2013 at 1:00 pm (CEDAR RAPIDS)
    Dummermuth Intergenerational Center, Four Oaks Bridge - The Great Room, 2100 First Avenue NE

  2. SEND IN WRITTEN COMMENTS OR QUESTIONS (due January 17).
    Deanna Jones
    Department of Human Services/Iowa Medicaid Enterprise
    100 Army Post Road
    Des Moines, Iowa 50315

  3. EMAIL YOUR COMMENTS OR QUESTIONS (due by June 17).
    dhsimehealthyiowaplan@dhs.state.ia.us

This is really the first step in the waiver request process.  States are to create these opportunities for public input, and use these comments to improve their waiver application. States must show how they addressed the issues raised by the public in their application to the Centers for Medicare & Medicaid (CMS).  Once the state submits its waiver application, the public will have another opportuniity to submit comments for CMS consideration. 

The Federal government has taken both rounds of public comments very seriously when deciding whether to approve or deny these ACA-related waivers.  They can approve a plan entirely, reject a plan entirely, or approve parts of the plan.  So, for instance, if they object to the premiums, they can approve the plan, but tell the state that it is not allowed to charge premiums. The state would have to come back next legislative session to fix it, but it wouldn't affect the plan going into affect January 1, 2014.  Similarly, if they decide transportation must be a covered service, they can accept the Iowa plan contingent upon that service being included.

___________________________________________________________________________________________________
TIPS TO REMEMBER WHEN OFFERING PUBLIC COMMENT:

  • Remember your comments are public record, and can be viewed by the public and the press.
  • Consider sending your comments to your legislators and the Governor.   
  • Tell a personal story to emphasize your points, if you are comfortable doing so publicly.
  • Suggest changes if you are concerned about something that is in the plan.
  • You can find more information on the plan here. For background, you can find more here.

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MH/DS Redesign Funding Finalized (but there's a catch)

After session-long debate over funding for the ongoing redesign of the mental health and disability services system, legislators came to a compromise.  The Senate wanted to distribute $42 million to all 99 Iowa counties based on a new funding formula that they say focused on real needs.  The House wanted to distribute $29.8 million, as planned in last year's bill, to the 54 counties that were unable to raise enough money locally to meet the "equalization target" (which allowed counties to budget $47.28 per person living in the county for mental health and disability services).

The compromise that was eventually included in the Standings Budget (Senate File 452):

  • Distributes $29.8 million to 54 counties whose levies raise less than $47.28/person.  These funds would "equalize" those budgets so that each of those counties has $47.28/person on hand to pay for non-Medicaid mental health and disability services.  Those funds will be distributed to the new regions, although they are calculated by county.

  • Adds $13 million to the Risk Pool, with priority given to the 45 counties that must reduce their property tax levies this year.  Counties that collected more than $47.28/person from local property taxes are required to cut their taxes, so they only collect that amount. They are not eligible for the "equalization funds" above.  They are simply out those dollars.  Some counties say that's okay, they don't need them. Others say they are in real trouble.  The Iowa State Association of Counties estimated that about 13 counties would be in real trouble, to the tune of about $6 million, although they agreed it was impossible to know for sure until the fiscal year ends on June 30.  This risk pool should be sufficient to meet those needs, in addition to any unexpected budget problems that occur because of legal settlement ending or other unexpected issues. 

  • Allows non-contiguous counties to join a region, if they have had a formal relationship with one of the counties in that region for at least two years.  Madison and Boone Counties have been partners in the delivery of mental health and disability services for many years, but the counties between them have chosen other regions.  This allows Madison to join with the Boone County region.

  • Clarifies that counties serving non-target populations (such as people developmental disabilities or brain injuries) can continue to do so if they have the funds available.  Advocates wanted to make sure that those counties going over and above the requirements in law would continue to be able to do that, as other counties worked to get to that level.  So, if one county serves people with autism (a developmental disability that is a non-target popualtion), they can continue to do so as long as they have funding.  They would not be forced to reduce their level of service in order to make every county in the state "equal."

  • Requires evidence-based practices, but also allows for innovative demonstration projects (called research-based practices).  There was some fear that evidence-based practices are very inflexible and do not allow for minor changes to the design in order to meet local needs (and they are very expensive to develop and implement).  Lawmakers feared if these practices were watered down too much, regions would continue to fund programs that do not produce good outcomes.  This balance was struck to require a high level of accountability, with the flexibility Iowans need to make the programs work.

  • Continues funding for a crisis stabilization pilot program in the region that includes Black Hawk County.  The program is limited to 10 beds and is only extended until June 30, 2014.  They are to submit a report by December 16, 2013 with recommendations on staffing levels, staff qualifications, admissions criteria, lengths of stay, transitions between services, facility requirements, and objectives/goals of future programs.

  • Requires all counties with outstanding Medicaid debt to pay those bills by July 15, 2013, or establish a payment plan with DHS to pay off by June 30, 2014.  Several counties have been holding these bills because they didn't have the money to maintain services and pay these bills without any state funds flowing into the system. Those counties have said they will pay these bills when equalization funds become available this year, but some of these counties will not receive the equalization payments and will continue to struggle to pay these off.

  • Distributes State Payment Program funds to the counties currently receiving them, using the last 12-month period as the baseline. Because the Legislature used federal funds that are subject to federal budget cuts (sequestration), they added language that directs DHS to use Medicaid funds to fill the gaps. So any federal cuts will not be passed on to the counties - but they will be made up with funds from Medicaid.

  • Continues the Children's Services Work Group and makes approved changes to data/statistical tracking as recommended by the work groups. One work group recommendation discussed a lot this year was not approved - the creation of a new "Children's Cabinet" made of up state agency heads that meet to develop strateges to address the needs of children.

For Senator Jack Hatch, this redesign was the result of more than a decade of work.  "This redesigned mental health system will provide equitable access to services statewide in the most effective manner," said Senator Hatch during final debate. "It will accomplish this by developing statewide standards that are regionally administered and locally delivered. Thanks to this redesigned system, clients will have timely access to individualized services that are consistent across the state.”

Now for that "catch" we mentioned at the beginning.  As part of the Health Care/Medicaid Expansion compromise, legislators will require counties to repay the state for any savings they get from this expanded health care coverage. Here is how it will work:

  • DHS will calculate how much each county will save because people that previously were served by the county MH/DS system will now have their services covered by Medicaid or private insurance approved by the Iowa Health and Wellness Plan.  This is called the "offset."  DHS will make this estimate and finalize it after review by the county auditor. 

  • Beginning next year (July 1, 2014), counties must repay this "offset" amount.  The money goes to back into the Property Tax Relief Fund (which is where equalization funds are placed).  The intent is that the Legislature won't have to appropriate as much in equalization funds each year, because the savings will make up part of that $29.8 million annual appropriation.  These offset payments are made annually.

  • Counties that must pay more than what they get in equalization funds and counties that get no equalization funds must reduce their MH/DS property tax levies by the amount of the offset.   So if a county saves $2 million, but only receives $1 million in equalization funds, it must reduce its county MH/DS property taxes by $1 million.  Legislators wanted Iowa's taxpayers to benefit from the "savings."

  • Legislators will study this issue in a "Medicaid Offset Study" this Summer and Fall.  They will look at the potential effects on the ability of the MH/DS regions to adequately fund core and core plus services, and recommend ways to address any funding shortages.

Legislators that supported this provision say that taxpayers should benefit from the Medicaid expansion, and counties should not look at this as a "windfall" and make decisions that are financially unsustainble.  Legislators that opposed this say that counties are already faced with challenges in making progress toward implementing core services, adding core plus services, and eventually working toward meeting the needs of non-target populations that have been waiting for services for some time (such as people developmental disabilities or brain injuries).  Counties will point out that it is difficult if not impossible to accurately track "savings" and any savings that does materialize should be used to meet core services requirements, make progress on core plus services, improve efficiencies as the system regionalizes, and begin to add evidence based practices (which are required, are expensive, and are not available in many areas of the state).

As you can see, this is an issue for the 2014 legislative session, and one we will be tracking this interim as the "Offset Study Commmittee" begins its work.  Stay tuned, and talk to your county supervisors and local CPCs to find out more about how this discussion will effect you at the local level.

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Legislature Approves Mental Health Advocate Bill

The Redesign Work Group that addressed issues involving the courts and public safety recommended what many thought was a small change - make the state's Mental Health Advocates employees of the Department of Inspections and Appeals.  Mental health advocates are currently hired and evaluated by the Judicial Branch, but their salaries are paid for with county tax dollars. Counties pay for the position, but have no say in who is hired or how they are doing.  

The work group felt it was very important for these advocates (who help Iowans that are going through the involutnary commitment process) to be independent, and that both the courts and counties have an interest in the decisions made.  To be truly conflict-free, the work group felt that mental health advocates needed to be a part of an independent state agency, like the Department of Inspections and Appeals.  

This bill became a magnet for all things controversial.  Legislators debated over which state agency was the most appropriate. They debated whether this was "expanding government" by increasing the number of state employees.  Others wanted to open up scope of practice issues, adding to the list of health care professionals that could evaluate individuals being involuntarily committed.  The bill started to buckle under the weight of this controversy, and many thought it was dead.

Just one week before the session ended, Rep. Dave Heaton of Mount Pleasant was able to negotiate a final deal that made the 60-plus advocates employees of the Department of Inspections and Appeals.  The bill ultimately passed 80-8 in the House, and unanimously (49-0) in the Senate.  The bill (Senate File 406) has not yet been signed by the Governor, but there is a $250,000 appropriation in the Health/Human Services Budget (Senate File 446) to create a Mental Health Advocate Division in the Department of Inspections and Appeals.

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State Budget Approved with 4% Spending Increase

The Legislature left town without touching the state's $600 billion surpus, and increased spending for the next year by only 4%. Here is a quick review of the state's biggest budget - the Health/Human Services Budget (Senate File 446):

  • Increases funding for the brain injury services in the Department of Public Health by $400,000 - including funding for a new Brain Injury Services Manager ($95,000).  Total funding is $891,644.

  • Adds a new $400,000 appropriation to establish a Regional Autism Assistance Program administered by the University of Iowa's Child Health Specialty Clinic.  Funds are to be used to enhance interagency collaboration and coordination of educational, medical and other human services for persons with autism, their familiees, and providers of services. Services are to include care coordination, family navigation, and integrated services.

  • Adds $2 million for a new Autism Support Program that will begin on January 1, 2014.  These funds will be used to pay for Applied Behavior Analysis for children that do not qualify for Medicaid or whose private insurance will not cover the services.
  • Continues funding at current levels for autism spectrum programs at Four Oaks in Cedar Rapids ($25,000) and at a Dubuque hospital ($25,000).

  • Increases funding for direct care worker recruitment and retention initaitives by $28,875 (total $178,875), funding for the Direct Care Worker Advisory Council by $26,500 (total $175,900), and maintains funding for direct care worker scholarships at the current level ($75,000).

  • Adds $300,000 to pay for the costs associated with House File 198, which allows Medicaid waiver service providers to include staff training costs in their direct costs (which are reimbursed by Medicaid).

  • Requires the Department of Public Health to develop a strategic plan to address health care workforce needs (including cost projections). The plan is to be submitted in a report by December 15, 2013.
  • Adds $8.7 million to reduce the number of people on the waiting list for Medicaid waiver services.  Legislative staffers estimate the cost to clear the waiting lists is about $11.5 million.

  • Requires people with intellecutal disabilities receiving Medicaid services receive a functional assessment (using the Supports Intensity Scale Tool) to determine their level of need, and DHS is to allocate funds for services according to that need.  DHS continues to receive $3 million to help develop and implement standardized assessment tools for persons with mental illness, intellectual disability, developmental disability, and brain injury.

  • Increases Medicaid provider rates by 1-5% depending on the provider type (1% for rehabilitation agencies; 3% for HCBS waiver providers).

  • Requires counties that didn't spend all of their MH/DS risk pool funds by June 30 return the money (it is then redirected to Medicaid).  Polk, Clinton and Scott counties have not yet spent all of their funds, and plan to return about $2 million to the state. These counties had hoped to keep the funds to help make ends meet.

  • Continues funding at current levels for the community circle of care collaboration for children and youth in Northeast Iowa ($1,436,595), Polk County ($327,947), and Cerro Gordo County ($160,000).  Language was added that directs DHS to determine the appropriate allocation of these funds in order to eliminate any duplication of services.

  • Adds $25,000 to the Prevention of Disabilities Policy Council (total $63,543) to pay for a summit with other organizations that advocate for or provide services to people with disabilities.  The summit is to review existing prevention activities, identify cost effective public policy options in preventing disabilities.
  • Includes new $250,000 appropriation to pay for the establishment of a new Mental Health Advocate Division in the Iowa Department of Inspections and Appeals.

  • Directs the Department on Aging, in collaboration with the University of Iowa's National Health Law and Policy Resource Center, to establish three pilot projects to train, recruit, and oversee volunteers to assist the courts in monitoring guardianships and conservatorships, and provide assistance to guardians and conservators.

  • Requires the Department of Human Services and Department of Inspections and Appeals to establish and facilitate a stakeholders group on to make recommendations on options to serve nursing home residents that are sexually aggressive, combative or have unmet psychiatric needs.  A report is due by December 15, 2013.

  • Requests the Department of Public Health and the National Center for Sports Safety conduct a municipal sports injury prevention study to address safety equipment for participants, and training needs of employees and volunteers.  A report is due January 10, 2014.

Because Medicaid runs out of money at the end of May, Senate File 446 also includes $34.3 million in "supplemental funding" needed to to ensure Medicaid services are funded until the end of the fiscal year (June 30).  The bill also includes the "Iowa Health and Wellness Plan" - the compromise that was reached to expand health coverage to 150,000 low income Iowans (covered in separate article).

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It's Not Over...Until the Governor Signs the Bill.

If you were successful in your advocacy this year, and got a bill passed, don't stop now!  It may feel like a final victory when your bill gets the votes it needs to make it through the legislative process, but there is one final and important step you won't want to overlook.  In order to become law, the bills passed by the Iowa Legislature, including budget bills, must be signed by the Governor.

The Governor has 30 days to sign bills (until June 22). He can sign a bill into law, or he can veto it   The Governor has even more flexibility when it comes to budget bills - he can "line item veto" these bills.  That means the Governor can sign the whole bill, but take out (veto) appropriations he doesn't like or thnk are necessary.

For example, the Governor could sign into law the $29.8 million appropriation to help 54 counties with the ongoing redesign of the mental health and disability services system, but veto the $13 million risk pool appropriation to help out the remaining 45 counties.

So do not make the mistake of declaring victory just yet!  It's not over until that signature is on the bill.  If you have something awaiting the Governor's signature:

  • Contact the Governor and let him know what you think. Ask him to sign bills or appropriations you want; ask him to veto those you do not like.  Make sure you reference the bill by number (for a short list look here; for a complete list of bills sent to the Governor this year click here). You can contact the Governor in the following ways:
  1. By Email here.
  2. By Phone (515-281-5211).
  3. By Letter (Governor Terry Branstad, 1007 East Grand, Des Moines, Iowa 50319)
  4. Use our Grassroots Advocacy Center to send the Governor a message here.
  • Encourage others to do the same. The more letters and contacts the Governor receives, the better your chances are of being successful.

  • Celebrate your advocacy success after the June 22 bill signing deadline passes!

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Advocacy in the Interim

Advocacy during the legislative session has its pluses and minuses. During the four (or so) months of the legislative session, you can find your legislators easily. You can email them at their legislative email addresses, and get a response.  They have staff to help research your issues and help keep up on letters, calls, emails, and requests.  They hold public forums and town hall meetings on the weekends to keep in contact with their constituents.  But while access may be easier, the time legislators have to address your concerns is very limited.  It's a short four months, and they are confronted with some of the most difficult of issues, like property tax reform, Medicaid expansion, education reform, and mental health and disability services redesign.  They must address farm issues and taxes, economic issues like business incentives and small business development, social issues like gay marriage and abortion, and topical issues like gun control and the death penalty.  They have alot to do in a short four-month window. 

So while advocating during the session months is timely, and you can easily find your legislators, your legislators do not have a lot of time to delve deeply into the issues.  That is why the interim period - the time when legislators are not in session - is a great time to lay the groundwork for your advocacy.  If you look at it like farming, the interim months (summer and fall) are the times where you plant your seeds and let them take root in your legislators' minds.  The session months (winter and spring) are the times when you cultivate and harvest your crop. 

During the interim, you will find your legislators at home, working their "real jobs" and taking part in community activities.  Some read their legislative emails, others ask their constituents to email their home emails.  Here are a few tips to finding your legislators when they are not in session:

  1. Find out who represents youClick here and be prepared to enter your address, with zipcode.

  2. Call or write your legislator at home.  You can get a list of home addresses and phone numbers here.
    • Be respectful of the time. Do not call during meal hours, and certainly not too early or late in the day.
    • Calls on weekends are fine, and probably preferred. 
    • Introduce yourself, and ask how they like to be contacted during the interim.
    • Ask if they check their legislative emails, and if not, ask for an alternative email address.
    • Offer to help on their campaigns, like marching in parades, helping with mailings, or door knocking.

  3. Find interesting ways to educate your legislators on your issues.
    • Host a "lunch and learn" with your legislators and others in your community.
    • Take your legislators on a tour that demonstrates the importance of your issue.
    • Meet for coffee with your legislators, and invite other community leaders.
    • Write letters to the editor, or meet with your local paper to encourage them to do a story on your issue.
    • Help others tell their stories - to make the issue personal.
    • Contact ID Action for other ideas!

So start planting those seeds now - and watch them grow when session comes around again in January!

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Monthly Advocacy Tip: Remember Thanks!

One of the most important rules in advocacy is to remember to say thanks.  If a legislator helped out on your issue, or voted the way you asked, it is important to let them know you noticed!  Even if the "thank you" is a "thank you for listening to me" - it's important.  Legislators remember who thanks them - and who took their hard work for granted.

  1. Send your legislators a hand-written note to their home addresses, thanking them for their work this session. Mention any specific issues that were important to you.  Ask them to let you know when they are having events this summer, or keep you posted on the issues you care about. Click here for a list of home addresses.

    OR

  2. Email your legislators using our Grassroots Advocacy Center here.

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Bill Tracker

The infoNET Bill Tracker tracks many bills of interest to Iowans affected by disability.  The "active" bills listed in the tracker are those passed by the Iowa Legislature and awaiting action by the Governor. Their status is updated daily - until all final action has occured (June 22, 2013).  You can also review bills that didn't make it this year by selecting "inactive" - those bills will become live rounds again when the Legislature returns in January 2014.

  • You can see this list in our Bill Tracker here.
  • You can see all bills passed this year by the Iowa Legislature here.
  • You can read detailed analysis of each budget bill passed this year here (just make sure you pick "final action").

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